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Limb salvage surgery with vascular reconstruction.
R E Leggon1, T S Huber, M T Scarborough
1W. Thaxton Springfield Center for Research and Education, Department of Orthopaedic Surgery and Rehabilitation, Gainesville, FL, USA.
Clinical Orthopaedics and Related Research
|June 13, 2001
Summary
Vascular reconstruction and limb salvage surgery offer a viable alternative to amputation for extremity malignancies involving major vessels. This approach achieved high limb salvage rates and good functional outcomes in a patient cohort.
Area of Science:
- Oncology
- Vascular Surgery
- Orthopedic Oncology
Background:
- Malignancies involving major extremity vessels pose a significant challenge in limb salvage.
- Traditional approaches may necessitate amputation, impacting patient quality of life.
Purpose of the Study:
- To evaluate the efficacy of vascular reconstruction and limb salvage surgery in patients with extremity malignancies involving major vessels.
- To assess oncologic control, limb salvage rates, and functional outcomes.
Main Methods:
- Retrospective review of 16 patients undergoing resection and reconstruction for extremity malignancies.
- Vascular grafting (14 patients) or rotationplasty (2 patients) were employed.
- Multimodal treatment including chemotherapy, radiation, and metastasectomy was utilized in select cases.
Main Results:
- Limb salvage was achieved in 88% of patients, with 50% alive without disease at a mean follow-up of 56 months.
- Good or excellent functional status was reported in 81% of patients.
- Local recurrence and infection rates were 12% each.
Conclusions:
- Vascular reconstruction and limb salvage surgery are effective in managing extremity malignancies involving major vessels, avoiding amputation.
- Despite significant complications, the approach offers acceptable local control and functional preservation.
- This strategy provides a viable option for patients facing limb loss due to cancer.